| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,567 |
1,474 |
$165K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,610 |
1,443 |
$137K |
| V2020 |
Frames, purchases |
2,603 |
2,341 |
$103K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,936 |
959 |
$50K |
| 92015 |
Determination of refractive state |
3,450 |
3,164 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
756 |
548 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
271 |
223 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
185 |
82 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
82 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
27 |
$2K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
30 |
12 |
$989.02 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
13 |
$980.00 |